THE VIEWS of doctors and other health professionals will form the central plank of the Health Service Executive’s new three-year corporate plan, its chief executive Prof Brendan Drumm has said.
Speaking in advance of an inaugural planning conference today between the HSE and senior clinicians, he said he wanted clinical directors and senior nurses to drive the next stage of transforming the health service.
He told The Irish Timesthe development of 18 integrated service areas (ISAs), as the basic building blocks of the health system, was well under way.
“In each ISA people working in hospitals will know the primary care teams they are serving and the people in the primary care teams can expect rapid access to all hospital facilities for their patients.”
The budget for each ISA will be managed by a single person, and will cross the hospital/community divide, he said.
Asked how the HSE could make budget savings, Prof Drumm claimed this could be achieved within a timeframe of “months”. He cited the use of medications in primary care and in hospitals as one ripe for savings.
“We need to focus on our responsibility to ensure the use of drugs is cost-effective and that there is a need to use them.”
He rejected concerns that forthcoming health cuts would be as blunt as those seen in the 1980s, pointing out that hospitals performing well would not be asked to take the same level of cuts as hospitals which are underperforming and “significantly overspent”.
Prof Drumm said he saw no reason why, with the co-operation of consultants, in the region of 20 per cent of a hospital’s diagnostic capacity could not be quickly turned over to direct GP access.
“Rapid access to diagnostics can be created quite quickly by giving people priority who are still outside the hospital.
“There is no point in us, for instance, continuing to run a system where we find a significant number of people sitting in a hospital bed who have been referred in there by a GP to get a CT scan or an ultrasound.”
On the issue of delivering health services in an equitable manner, he said the HSE was working with Dr Frank Heimig of INEK, the German Institute for Hospital Remuneration Systems, to design a new resource allocation programme.
INEK has pioneered a system whereby funding for a particular hospital procedure, such as hip replacement, is calculated.
However, if the number of procedures exceeds this funding level, hospitals must continue to offer the treatment, but for a reduced fee from the exchequer.
Among the workshops being run at today’s conference, jointly hosted by the Forum of Irish Postgraduate Medical Training Bodies, is a discussion on whether the health service can cope with rising levels of chronic illness.
Other topics include, “are we distributing funds fairly?” and “is full service integration achievable?” The principal speaker will be Dr Jean Drouin, a partner with management consultants McKinsey in London and an expert in health system reform.